Fluid Increase A Puzzle

GOOD HEALTH - Dr. Paul Donohue

October 30, 1995|Dr. Paul Donohue

Dear Dr. Donohue: I am a 29-year-old woman. Four years ago, I was diagnosed with "pseudotumor cerebri."The first treatment was with Decadron. Then I was switched to Diamox. Could you please explain the cause of this problem? - J.

Dear J.: Its name tells us most of what you need to understand pseudotumor cerebri. It is a condition that produces all the symptoms of a brain tumor but without any tumor. Most often, the patient is a woman, age 20 to 24, on the heavy side.

The chief cause of pseudotumor cerebri is a rise in the volume of spinal fluid, which also circulates in the brain. That produces pressure and the tumorlike symptoms: headache and vision irregularities. What causes the increase is unclear.

The need to lower spinal fluid pressure dictates treatment, for if it stays up, vision can be impaired. Your doctor began that process with Decadron, a cortisone drug. Patients also are treated with the diuretic drug Diamox, which slows fluid production. Treatment is usually successful. The problem recurs in about 8 percent of patients. You would treat a recurrence the way you did the original episode.

Dear Dr. Donohue: I have been plagued with migraines for 10 years. I get them really bad when I smell certain distinct or offensive odors, such as nail polish fumes. Is the sense of smell in some way connected with headaches like this? - K.W.

Dear K.W.: Pungent odors can detonate migraines. In fact, many similar phenomena get involved in migraines. A change in diet or sleep habits can trigger migraines. So can bright sunlight, alcohol or menstruation. If you have many migraines, you should seek some form of prevention, such as Inderal or a similar beta blocker drug.

Dear Dr. Donohue: What is vitamin K? How does it affect blood? - Mrs. B.

Dear Mrs. B.: Vitamin K quietly plays an important role in the production of blood-clotting proteins, without which we'd all bleed to death.

Vitamin K is omnipresent in nature to the point you seldom have to look for it in bottles. Green-leaf vegetables have lots of it. Adults usually don't have to worry about getting the required micrograms of K: 60 for a woman; 80 for a man.